I just wanted to get some advice here
I've been a nurse for about 5 months. I was on the floor a few days ago had a new admission from ER. I was doing night shift 7-7, the man was confused, a dnr from nursing home with cancer. He's in his late 80's and the confusion was a new onset from when I got him he was apparently not confused in the ER and daughter accompanied him. She stayed the night but said after that night no one would be staying with him bc the family is scattered everywhere.
Anyways during my shift he tried to climb out of bed about 6 times. I caught him each of the 6 times because I checked on him q 30 min while his daughter got some much needed sleep in our seating area. Each time he gets up to "pee" he hates wearing a diaper even though he let me out one on him, forgets the trials beside him. By the way he cannot walk his gait is super unsteady and apparently was bed bound at nursing home for about a month before admission with his wife taking care of the soiled beds he would leave.
So would keep reassuring him of where he was gave him prn Ativan twice that night. Then at 6am I got kind of fed up with him getting out if bed again as I was so busy and put him in a Geri chair beside the nurses station. I don't believe in heavily medicating seniors so even though he had haldol ordered as needed (apart of an admission order set) I decided not to use it as he was not aggressive but became more insistent and irritable as the night went on.
So the daughter (who I woke up a few times that night to come over abd reassure him) gave permission to use soft restraints finally at like 630 am)
So I'm giving report to the oncoming nurse and she ripped into be for not giving the guy haldol. I told her I didn't think he needed it and I've noticed in several elderly patients that when they do get haldol frequently they are more confused/lethargic and since he wasn't confused in the ER I was waiting it out. Note patient at this time was in the Geri chair calm almost sleeping /looking out the window.
Do you think in this instance I should have used the haldol earlier in the night? It certainly would have made my night easier because I ran my feet off. I'd just like some advice I seem to always have confused patients and in sure ill come across this scenario again soon....